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Contract Number Brand Code Brand Name Active Ingredient Trade Name Package Size Formulary Category Pkg Price Unit Price Unit Description Max. Reimbursable Quantity / Month Package Description Manufacturer Code Manufacturer Name Agent Code Agent Name Benefit Therapeutic Code Therapeutic Desc Drug Contract Start Date Drug Contract End Date Status Description Default Route Max Repeats Therapeutic Head Amend Date
40 4811D HYDROXYCOBALAMINE 1MG/ML INJ (RTM/PHA) HYDROXYCOBALAMINE HYDROXYCOBALAMINE 10X1ML B 14.90 1.49 INJECTION 0 AMP RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 8808 VITAMIN B COMPLEX 2022-04-01 2024-03-31 IV 0 VITAMINS
42 4811D HYDROXYCOBALAMINE 1MG/ML INJ (RTM) HYDROXYCOBALAMINE HYDROXYCOBALAMINE 10X1ML B 13.86 1.39 AMPG 3 BOX RTM PANPHARMA GMBH PHA PHARMACY SALES CARIBBEAN 8808 VITAMIN B COMPLEX 2026-04-01 IV 0 VITAMIN B COMPLEX
41 4811M HYDROXYCOBALAMINE 1MG/ML INJ (KWA) HYDROXYCOBALAMINE HYDROXYCOBALAMINE 10X1ML B 67.9309 6.7931 AMPP 3 BOX KWA KWALITY PHARMACEUTICALS ATB ANSA TRADING BARBADOS LTD 8808 VITAMIN B COMPLEX 2024-04-01 2026-03-31 IM 0 VITAMIN B COMPLEX
42 4811Q HYDROXYCOBALAMINE 1MG/ML INJ (FSB) HYDROXYCOBALAMINE HYDROXYCOBALAMINE 10X1ML B 16.72 1.67 AMPG 3 FSB FLAGSHIP BIOTECH STO BRYDEN STOKES LTD 8808 VITAMIN B COMPLEX 2026-04-01 Add to Contract as Cat B IM 0 VITAMIN B COMPLEX 2026-03-05